Severe gut paralysis

Enricks

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Jul 20, 2018
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#1
@Helen I need serious help!!! It's really urgent.

This problem started 8 day ago. I took loperamide for a few days. Then, I drunk some licorice tea for days. I stopped licorice 8 days ago because I suspected that caused my nonexistent bowel movements.


At school, My gut bloathes when there is acut stress. But there is no regular motility down here. My gut doesn't move anymore. Even lactulose didn't help(15 ml yesterday, 45 ml today). There is zero response to laxatives.

I haven't been pooped for 8 days and today it was hurting A LOT. But still zero urge to poop.

Doctor gave me enema, but it just worked a little. My bowel didn't reacted to 10 grams of laxative as well.


I suspect licorice or loperamide wrecked havoc on sympathetic/parasympathetic balance. Pseudo-obstruction or whatever, that's something caused by nerves and hormones, I believe.

Also after licorice, my tinnitus increased a lot.

@Helen I need urgent help because I don't know how to explain this to doctors. It's very bad, it hurts but I can't do anything.
 

Helen

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Oct 5, 2017
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#3
@Enricks

Loperamide is an opioid-receptor agonist and acts on the μ-opioid receptors in the myenteric plexus of the large intestine. It works like morphine, decreasing the activity of the myenteric plexus, which decreases the tone of the longitudinal and circular smooth muscles of the intestinal wall.[31][32] This increases the time material stays in the intestine, allowing more water to be absorbed from the fecal matter. It also decreases colonic mass movements and suppresses the gastrocolic reflex.[33]

Loperamide's circulation in the bloodstream is limited in two ways. Efflux by P-glycoprotein in the intestinal wall reduces passage of loperamide, and the fraction of drug crossing is then further reduced through first-pass metabolism by the liver.[34][35] Loperamide metabolizes into an MPTP-like compound, but is unlikely to exert neurotoxicity.[36]

Blood–brain barrier[edit]
Efflux by P-glycoprotein also prevents circulating loperamide from effectively crossing the blood–brain barrier,[37] so it can generally only antagonize muscarinic receptors in the peripheral nervous system, and currently has a score of 1 on the anticholinergic cognitive burden scale.[38] Concurrent administration of P-glycoprotein inhibitors such as quinidine potentially allows loperamide to cross the blood–brain barrier and produce central morphine-like effects. Loperamide taken with quinidine was found to produce respiratory depression, indicative of central opioid action.[39]

Loperamide has been shown to cause a mild physical dependence during preclinical studies, specifically in mice, rats, and rhesus monkeys. Symptoms of mild opiate withdrawal were observed following abrupt discontinuation of long-term treatment of animals with loperamide.[40][41]

When originally approved for medical use in the United States, loperamide was considered a narcotic and was put into Schedule II of the Controlled Substances Act 1970. It was transferred to Schedule V on 17 July 1977 and then decontrolled as of 3 November 1982.[42]




I would try what @HerrFisch suggested.

If no good, I would try something to increase acetylcholine.
 

Enricks

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Jul 20, 2018
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#4
Tried Magnesium Citrate?
Yes. I tried magnesium sup which has citrate, bisglycinate and maleate. It didn't help.

things that draw water into the digestive track?
Lots of lactulose... Zero effect. My bowel is unresponsive to everything. Sorbitol+glicerol enema didn't helped much either.


Eating 3+ apples? (pectin)
Ate some apple this morning, but apperantly they have made no effect either.

@Helen Loperamide's effect must have been subsided. It's been a week. Is it a permanent effect?
 

Enricks

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Jul 20, 2018
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#5
A few minutes ago I went to toilet. I thought I can finally do it, but I couldn't. I only excreted the water that lactulose pumped up in my bowel. And, my gut really hurts right now. I just ate meal.

If I can't find a solution, this problem could require a surgery. I don't even want to think about it.

@Helen Severe intestinal pseudo-obstruction following withdrawal from over-the-counter steroid abuse Sharma A, Naraynsingh V, Goalan R, Teelucksingh S T - J Postgrad Med

What do you think about it? adrenal pseudoobstruction - Google Search
 

Helen

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Oct 5, 2017
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#6
A few minutes ago I went to toilet. I thought I can finally do it, but I couldn't. I only excreted the water that lactulose pumped up in my bowel. And, my gut really hurts right now. I just ate meal.

If I can't find a solution, this problem could require a surgery. I don't even want to think about it.

@Helen Severe intestinal pseudo-obstruction following withdrawal from over-the-counter steroid abuse Sharma A, Naraynsingh V, Goalan R, Teelucksingh S T - J Postgrad Med

What do you think about it? adrenal pseudoobstruction - Google Search

did you try potassium? potassium raises cortisol

in this article that you gave me, they gave corticosteroids to get rid of constipation.


If potassium would not help, then it is probably acetylcholine problem.

Usually acetylcholine increases Nitric oxide, which then pushes potassium out of the cell.

SO if you lower cellular potassium, this will lower acetylcholine,

and acetylcholine increases gut movement


So you took 2 things which lower cell potassium, licorice, and this other drug which directly kills acetylcholine


I mean that other drug is used to slow the gut movement, and it uses acetylcholine blockage to do it.

how long that blockage lasts, I am not sure.


several PSSD cases have very low progesterone also. May be you are one of those cases. I don;t know

if you were that case, then you already had very low potassium.

since progesterone in the body goes up to retain potassium and if you can't make progesterone then your potassium could have been already low.
 
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MCurtone

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Apr 7, 2019
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#7
Enricks, please stop eating and fast for some time. I had symptoms similar to you and it turned out to be appendicitis. Fast for some time and stop putting pressure on the digestive system.
 
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tanedout

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Oct 17, 2017
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#8
Psyllium husk is very high fibre & might help.

I got totally constipated when I did a paleo diet, but once I introduced a whole grain bread again then after a day or two things started to get back to normal, but before that my bowel felt like concrete
 

HerrFisch

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Oct 7, 2017
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#10
Psyllium husk is very high fibre & might help.

I got totally constipated when I did a paleo diet, but once I introduced a whole grain bread again then after a day or two things started to get back to normal, but before that my bowel felt like concrete
Would not dare trying psyllium in this situation.
Especially if there is a possibility for intestinal obstruction. Could just add to more volume -> more pain.

Theoretically it should be pretty easy to trigger diarrhea. But you need to take bigger dosages of for example magnesium.
Maybe use some form that binds extra water like hexahydrate.


I’ve read your post on raypeat and you mentioned you took 200mg of some mg 3 -blend. come on. @Enricks

glycinate is perfect for people that don’t want to have diarrhea from magnesium
 
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bruschi11

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Oct 3, 2017
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Boston, MA
#12
@Helen I need serious help!!! It's really urgent.

This problem started 8 day ago. I took loperamide for a few days. Then, I drunk some licorice tea for days. I stopped licorice 8 days ago because I suspected that caused my nonexistent bowel movements.


At school, My gut bloathes when there is acut stress. But there is no regular motility down here. My gut doesn't move anymore. Even lactulose didn't help(15 ml yesterday, 45 ml today). There is zero response to laxatives.

I haven't been pooped for 8 days and today it was hurting A LOT. But still zero urge to poop.

Doctor gave me enema, but it just worked a little. My bowel didn't reacted to 10 grams of laxative as well.


I suspect licorice or loperamide wrecked havoc on sympathetic/parasympathetic balance. Pseudo-obstruction or whatever, that's something caused by nerves and hormones, I believe.

Also after licorice, my tinnitus increased a lot.

@Helen I need urgent help because I don't know how to explain this to doctors. It's very bad, it hurts but I can't do anything.
I went through a lot of this the past year. It’s intricate and there’s not a 1 way street of getting out of this. There are a lot of factors.

Hang in there. Stay calm. If it were me I’d get some testing done ASAP and then go into a fast for 5 days or so. Fill up on magnesium while fasting from magnesium chloride baths. Do you have hair tests from the past?

I got out of this and so did @5alpha. You will too
 

bruschi11

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Oct 3, 2017
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#13
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BC2018

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Nov 27, 2018
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#14
Yes. I tried magnesium sup which has citrate, bisglycinate and maleate. It didn't help.
They sell Magnesiun Citrate in a small bottle for $2 at the grocery and drug stores. It's the same thing as Epsom Salts but in liquid form so it works faster and it's what they use at the hospital to clear your colon. I think it's safer than epsom salts. Don't drink the whole bottle unless you want explosive diarrhea. Drink 1/3 and wait 20 minutes.
 

Enricks

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Jul 20, 2018
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#15
I bought mag sulphate. But firstly planning to solve the thing whatever causing my tinnitus to worsened. Because that I got some high cortisol responses, I guess the tinnitus is from elevated blood pressure or volume. Btw, the tinnitus keeps worsening, idk why.

Also my need for water is increased a lot. But I'm trying to keep it at normal because I'm scared of odema, swelling. I already have some random headaches.

I have dry mouth also.

The type 2 isoenzyme of 11 beta-hydroxysteroid dehydrogenase (11 beta-HSD2) is normally involved in regulating corticosteroid specificity in the gastrointestinal tract, kidney and salivary glands (see figure 1).6 Cortisol (not aldosterone) is metabolized by 11 beta-HSD2 to cortisone, which does not bind to either the mineralocorticoid or glucocorticoid receptor. Without this inactivation of cortisol, there would be mineralocorticoid excess. In fact, there is an inherited disease called syndrome of apparent mineralocorticoid excess in which the mineralocorticoid receptor is overly activated thereby causing hypokalemia and hypervolemia due to the excessive reabsorption of sodium and water at the expense of potassium excretion. This is the same effect created by licorice use.
The Mechanism for Licorice (Glycyrrhiza glabra) Induced Swelling and Edema




I heard that withdrawal from licorice can lasts for months. I still have zero urge to poop. Am I have to apply enema every 4-5 days? Is mag sulphate more potent than lactulose? Yesterday, lactulose didn't helped, I only excreted some water and a little bit of feces. So I don't think making myself dierrhatic will solve the issue.

Do you know any natural aldosterone antagonists? (Except pregnenolone and progesterone. Preg is not being sold here, prog is only at 100 mg doses(soft capsule)). Once I tried 100 mg at once and it was no good, but I haven't got any diarrhea at that time.


Is potassium chloride or low-sodium-salt a good choice? @Helen
 

Enricks

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Jul 20, 2018
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#16
Also, what about coffee? I heard that it inhibits cortison to cortisol conversion, but mainstream says otherwise. Also I wouldn't want to suffer more, I can hear my tinnitus all the time now.

Yesterday I checked my tension, it was 140/75 85 pulse. Not bad but idk.
 

Helen

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Oct 5, 2017
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#17
Also, what about coffee? I heard that it inhibits cortison to cortisol conversion, but mainstream says otherwise. Also I wouldn't want to suffer more, I can hear my tinnitus all the time now.

Yesterday I checked my tension, it was 140/75 85 pulse. Not bad but idk.
it will downregulate your Beta-1 receptor.


you might get a little better after this.
 

Seekinghealth

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Apr 11, 2019
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#18
Perhaps, sounds like hypokalemia. This can lead to Paralytic ileus.

Metabolic disturbances, such as decreased potassium levels, etc. Paralytic ileus is marked by abdominal distension, absent bowel sounds and relatively little pain.... Early paralytic ileus is marked by decreased or absent bowel sounds.

Paralytic Ileus - an overview | ScienceDirect Topics

Tinnitus often has high intracelluar calcium, this leads to potassium loss.

You have widended pulse-pressure. Have you urinated alot?
 
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Enricks

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Jul 20, 2018
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#19
Perhaps, sounds like hypokalemia. This can lead to Paralytic ileus.

Metabolic disturbances, such as decreased potassium levels, etc. Paralytic ileus is marked by abdominal distension, absent bowel sounds and relatively little pain.... Early paralytic ileus is marked by decreased or absent bowel sounds.

Paralytic Ileus - an overview | ScienceDirect Topics

Tinnitus often has high intracelluar calcium, this leads to potassium loss.

You have widended pulse-pressure. Have you urinated alot?
No, actually I'm urinating a lot less.

If that's the problem perhaps, adding some potassium salt to meals may help?

Elevated calcium maybe the additional factor, because I'm eating cheese every morning.
 

Seekinghealth

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Apr 11, 2019
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#20
I can only make a guess again,

But Brenner and Rector's The Kidney E-Book

Pulse pressure increases in a intracelluar-potassium shift as in a alkalosis.
I believe this gives you the thirst symptomps and no water or calcium can clench this. Probaly makes this worse.

How is your breathing slowed-down ?
 
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